Acute kidney success versus acute kidney injury

Acute kidney injury is considered by a sudden regression in kidney function, following an incapability to secrete waste products and to keep electrolyte and water balance (۱,۲). This condition is related to high risks of morbidity and death. Kidney improvement was described as a decrease in a serum creatinine level to the normal value. Acute kidney injury or acute renal failure necessitates to be distinguished early and primary triggers treated or eradicated (۱-۳). Acute renal failure is frequently multifactorial. Several factors like hemodynamic instability, major surgeries (i.e. cardiac surgery), sepsis, trauma, drug toxicity, radiocontrast agents and hypovolemia are the most popular causes of this condition, however, patients with underlying diseases have increased liability. Regardless of most dissimilar etiologies, pathophysiologic factors that happen concurrently in series, are endothelial dysfunction, modification of the microcirculation and renal tubular cell damage, then venous congestion happened and finally interstitial inflammation. Even milder forms of acute kidney injury have enhanced probability of morbidity and mortality (۲-۵). Acute renal failure complicates around ۲۰% of hospitalizations, getting rates up to ۴۰% in critically ill individuals. Numerous large observational investigations have detected link of acute renal failure with mortality in hospitalized individuals. Importantly, mortality has been connected to increase the severity of acute renal failure (۱-۶). Main risk factors for acute kidney injury at the patient’s situation, are older age, the presence of chronic kidney disease, diabetes, hypertension, cardiovascular disease, hepatic problems, and lung disease. Regarding the large proportion of patients affected by acute kidney injury, the sequelae of acute renal failure may be a very large public health problem. Additionally, there are growing evidence, that acute kidney injury is an pivotal factor for chronic renal failure. Various investigations have detected a link between acute renal failure and long-term mortality and particularly progress of chronic renal failure and even development of end-stage kidney failure (۳-۶). In the recent decade, a tight link between acute kidney injury and progression to chronic renal failure has obtained increasing consideration by numerous large epidemiological investigations. In fact, even a complete recovery from acute kidney injury has been proposed to predispose to long-term harmful outcomes, while absent or only partial recovery further provokes this predisposition (۲,۴-۷).

کلیدواژه ها:

Acute kidney injury ، Chronic kidney disease ، Renin–angiotensin system ، Diabetes ، Hypertension ، Cardiovascular disease